Health Care for Consumers

Trends for the Health Care Consumer

Dr. Dre
University of Phoenix



Introduction

Today, health care insurance is meant to cover a wide range of services that are, or will be needed to help individuals take control and manage their needs as they apply to health care. There are four different types of health care insurances: health maintenance organizations (HMOs), point of service plans (POS), preferred provider organizations (PPOs), and exclusive provider organizations (EPOs), all of which have their own pros and cons. Individuals who receive their health care plan from an employer gain the biggest benefit with majority of companies offering to pay (in some instances) half of the total to cover an employee’s health care costs. Health care coverage isn’t a requirement for an employer, with companies operating with less than 50 total employees choosing to offer other incentives to employees. A pro, as it applies to individual health insurance, is that the plan stays with the employee if they switch jobs. Market trends tend to be based on factors of a health care plan such as what it covers, any out of pocket costs, or how the plan affects individuals with pre- existing conditions.

Trends for the Health Care Consumer

Since the Affordable Care Act (ACA) has gone into legislation, health care providers have viewed the legislations as an opportunity to create health care plans that would benefit the individual, the health care provider, and the market as a result. Considering premiums, the monthly cost of each depends on factors such as age, the state that the individual lives in, and any pre- existing conditions. With a visit to your doctor, you may have to pay a deductible which is any out of pocket costs that an individual will have to pay before their actual health insurance comes into play to pay the remainder. Visits for services such as disease management or checkups are typically covered by most plans and don’t require a deductible to be paid by the individual. Deductibles may still apply, however, under the same plan, for certain benefits such as prescription drugs which are categorized as separate deductibles. As a result of ACA, deductibles have increased over the years with the average deductible in 2014 being $4,164 and raising to $4,578 in 2018. This is a direct reflection of federal and state health care policies and health care providers understanding trends, based on policies, and adjusting to the market based on the necessity for individual health care.

References

Jost, T., S. (2019). How Will State and Federal Actions Affect Individual Health Insurance Coverage for Middle-Income Americans? Retrieved from https://www.commonwealthfund.org/blog/2018/how-will-state-and-federal-actions-affect-individual-health-insurance-coverage-middle

Advantages and Disadvantages of Health Insurance. (2019). Protective. Retrieved from protective.com/learning-center/life-101/policy-types/advantages-and-disadvantages-of-health-insurance/

Cigna. (2019). Types of Health Insurance. Retrieved from https://www.cigna.com/individuals-families/understanding-insurance/types-of-health-insurance

The Commonwealth Fund. (2019). Health Insurance Coverage Eight Years After the ACA. Retrieved from https://www.commonwealthfund.org/publications/issue-briefs/2019/feb/health-insurance-coverage-eight-years-after-aca

Merhar, C., (2019). New Advantages of Individual Health Insurance. Retrieved from https://www.peoplekeep.com/blog/bid/318559/New-Advantages-of-Individual-Health-Insurance

Hunt, J. (2019). What is the Average Health Insurance Premium? Retrieved from https://www.thebalance.com/what-is-the-average-health-insurance-premium-4586358